Pandemic and All-Hazards Preparedness and Advancing Innovation Act

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Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019
Great Seal of the United States (obverse).svg
Long titleAn act to reauthorize certain programs under the Public Health Service Act and the Federal Food, Drug, and Cosmetic Act with respect to public health security and all-hazards preparedness and response, and for other purposes.
Enacted bythe 116th United States Congress
Citations
Public law 116-22
Legislative history

The Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI) is legislation introduced and passed by the U.S. Congress in 2019 that aims to improve the nation's preparation and response to public health threats, including both natural threats and deliberate man-made threats. [1]

Contents

A previous bill (with a near-identical name), the Pandemic and All-Hazards Preparedness Act (PAHPA), was signed into law in 2006 and reauthorized in 2013 in order to create a system that prepares for, and responds to, public health threats that could turn into emergencies.

The 2019 bill (PAHPAI) was introduced by U.S. Senators Richard Burr (R-NC), Bob Casey (D-PA), Lamar Alexander (R-TN), and Patty Murray (D-WA). [1] Congress passed the bill and sent it to President Trump for his signature in June 2019. (The bill number is S. 1379).

Background

After the September 11, 2001 terrorist attacks and the anthrax attacks that followed, a critical need arose: to develop and stockpile medical countermeasures (certain drugs and vaccines) needed to protect people from chemical, biological, radiological, nuclear (CBRN) and pandemic threats. [2]

However, medical countermeasures that address these types of threats, such as anthrax or the plague, have little or no commercial market. Therefore, the government needed to incentivize the private market to develop them. To do so, Congress passed the Project BioShield Act in 2004. That law created a federal program called the Special Reserve Fund (SRF) to incentivize development of these types of medical countermeasures. [2]

The reward poster for the capture and arrest of the perpetrator of the 2001 anthrax attacks. Anthraxreward.jpg
The reward poster for the capture and arrest of the perpetrator of the 2001 anthrax attacks.

Since 9/11, the United States has faced a number of additional sizable public health emergencies. The anthrax attacks of 2001, the destruction caused by Hurricane Katrina in 2005, and the Ebola outbreak in 2014 all raised alarm and concern about how the government should prepare for, and respond to, such events. Because of these events, Congress has attempted to vastly improve the federal government's ability to address these threats. [3]

In 2006, passage of the Pandemic and All-Hazards Preparedness Act (PAHPA), among other things, created the Biomedical Advanced Research and Development Authority (BARDA) to provide companies with money and technical assistance in the advanced research and development of medical countermeasures. [2]

Several key existing laws give authorities, budgets and policies and procedures to several government agencies tasked with responding to public health emergencies. [3]

When disasters such as wildfires, hurricanes, and disease outbreaks strike, many sectors (public health, healthcare, and the private sector) play a role in saving lives. According to the American Hospital Association, PAHPA is “the backbone of our nation’s health security” by giving the U.S. Department of Health and Human Services (HHS) the authority to respond to disasters. [4]

After implementing the 2013 PAHPA reauthorization, Congress recognized certain federal programs, policies and procedures that needed improvement. The purpose of the 2019 PAHPAI bill is to implement these improvements. [4]

Bioterrorism and antimicrobial resistance

PAHPAI focuses on a variety of threats, but pays special attention to two specific threats: bioterrorism and “antimicrobial resistance.”

Bioterrorism occurs when a person or group of people intentionally release germs that can cause serious illness or death. Depending on the type of germ (also known as a “biological agent”), sometimes bioterrorism attacks can go almost completely undetected by technology because the biological agents are so microscopic in size.

Another emerging public health threat that is causing concern is the increase in “microbial resistance” among infectious diseases. Microbial resistance occurs when a person who has an infectious disease is given a countermeasure, such as an antibiotic medicine, and it does nothing to help the person get better. [3]

Therefore, one of the goals of the PAHPAI law is to develop new therapies that are effective at treating infectious diseases. [3]

Provisions of the legislation

Nuclear, biological and chemical (NBC) disposal technicians taking part in a training exercise US Navy 040117-N-0331L-023 Nuclear, Biological, and Chemical (NBC) disposal technicians from the 1st Marines 1st Battalion prepare to search the Military Sealift Command (MSC) combat stores ship USNS Saturn (T-AFS 10).jpg
Nuclear, biological and chemical (NBC) disposal technicians taking part in a training exercise

An “authorization” bill in Congress is legislation that creates, or continues, the existence of federal agencies and programs. Authorization bills also define the terms and conditions under which the agencies and programs operate, authorize Congress to appropriate funds to those programs, and spell out how the programs must use their funds. Therefore, a “reauthorization” bill is legislation that redefines these specifics for federal agencies and programs. [5]

PAHPAI reauthorizes federal government programs that were established in the past by the Public Health Service Act and the Federal Food, Drug, and Cosmetic Act. The law makes significant changes and improvements to the agencies and programs under those two laws, in order to make the federal government more effective at preventing and responding to public health security threats such as bioterrorism attacks or disease outbreaks. [3]

PAHPAI focuses on making changes in the law in order to improve the government's response to a number of public health threats, including: [1]

The legislation is divided among seven titles which are described below.

Title I - Strengthening the National Health Security Strategy

Title I changes the National Health Security Strategy (NHSS) so that it includes a detailed description of all public health threats, as well as the processes to respond to each type of threat and emergency. It also adds zoonotic disease and disease outbreaks related to food and agriculture into the National Health Strategy. [6]

The NHSS is a vision, set forth by HHS, to responding and managing public health emergencies. According to HHS: [7]

The 2019-2022 National Health Security Strategy (NHSS) provides a vision to strengthen our nation’s ability to prevent, detect, assess, prepare for, mitigate, respond to, and recover from disasters and emergencies. It describes strategies to improve readiness and adapt operational capabilities to address new and evolving threats. By coordinating a whole-of-government approach that engages external partners and supports public health authorities and health care stakeholders, we can better safeguard the health and well-being of people across the country.

The NHSS is created every four years by HHS and the Office of the Assistant Secretary for Preparedness and Response (ASPR). [8]

Title II - Improving Preparedness and Response

Title II is further divided into 10 sections: [6]

Title III - Reaching All Communities

Medical Reserve Corps volunteers look over papers Medical Reserve Corps volunteers look over papers.jpg
Medical Reserve Corps volunteers look over papers

Title III is further divided into six sections: [6]

Title IV - Prioritizing a Threat-Based Approach

Official logo for the Assistant Secretary for Preparedness and Response ASPR Logo large.jpg
Official logo for the Assistant Secretary for Preparedness and Response

Title IV is further divided into five sections: [6]

Title V - Increasing Communication in Medical Countermeasure Advanced Research and Development

Title V is further divided into five sections: [6]

Title VI - Advancing Technologies for Medical Countermeasures

US Navy 070405-N-1525H-034 Airman Mark Hensel receives the anthrax vaccine aboard the nuclear-powered aircraft carrier USS Nimitz (CVN 68) US Navy 070405-N-1525H-034 Airman Mark Hensel receives the anthrax vaccine aboard the nuclear-powered aircraft carrier USS Nimitz (CVN 68).jpg
US Navy 070405-N-1525H-034 Airman Mark Hensel receives the anthrax vaccine aboard the nuclear-powered aircraft carrier USS Nimitz (CVN 68)

Title VI is further divided into seven sections: [6]

Title VII - Miscellaneous Provisions

Title VII is further divided into seven sections: [6]

Legislative history

Original law

President George W. Bush and Senator Richard Burr George W. Bush and Richard Burr.jpg
President George W. Bush and Senator Richard Burr

In 2006, during the 109th Congress (2005-2006), Senator Richard Burr introduced S. 3678, the Pandemic and All-Hazards Preparedness Act. It passed Congress and was signed into law by President George W. Bush (Public Law 109-417). [16]

Senators Richard Burr and the late Edward Kennedy (D-MA) spearheaded the original legislation. [1]

First reauthorization

In 2013, the original Pandemic and All-Hazards Preparedness Act of 2006 needed to be reauthorized. Senator Richard Burr introduced S. 242, the Pandemic and All-Hazards Preparedness Reauthorization Act. The bill, however, never made it to a full vote in the Senate. [17] In the House, Rep. Mike Rogers introduced the same legislation, H.R. 307. That bill passed Congress and was signed into law by President Barack Obama (Public Law 113-5). [18]

Second reauthorization

In 2018, during the 115th Congress (2017-2018) the law once again needed to be updated and reauthorized. Senator Burr introduced S. 2852, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018. The bill made it through committee consideration but never reached a full vote in the Senate. [19] In the House, Rep. Susan Brooks introduced companion legislation, H.R. 6378. Brooks’ bill passed the House, but was never considered in the Senate. [20] Once the 115th Congress ended, both bills were effectively dead.

The following year, in 2019 during the first year of the 116th Congress (2019-2020), Senator Burr re-introduced the All-Hazards Preparedness and Advancing Innovation Act as S. 1379. The bill was passed by Congress and on June 24, 2019 it was signed by President Trump on June 24, 2019 (PL 116-22). [21]

Table summary of legislative versions

Various versions of the PAHPA bill
SessionChamberBillSponsorStatus
109th Congress (2005-2006)SenateS. 3678 - Pandemic and All-Hazards Preparedness Act Sen. Richard Burr (R-NC)Signed into law (PL 109-417)
109th Congress (2005-2006)HouseNoneN/AN/A
113th Congress (2013-2014)SenateS. 242 - Pandemic and All-Hazards Preparedness Reauthorization ActSen. BurrIntroduced in Senate. No vote.
113th Congress (2013-2014)HouseH.R. 307 - Pandemic and All-Hazards Preparedness Reauthorization Act Rep. Mike Rogers (R-MI)Signed into law (PL 113-5)
115th Congress (2017-2018)SenateS. 2852 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018Sen. BurrReported favorably out of the Senate HELP Committee. No vote in the full Senate.
115th Congress (2017-2018)HouseH.R. 6378 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018Rep. Susan Brooks (R-IN)Passed in House. No consideration in Senate.
116th Congress (2019-2020)SenateS. 1379 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019Sen. BurrSigned into law (PL 116-22)
116th Congress (2019-2020)HouseH.R. 269 - Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019Rep. Anna Eshoo (D-CA)Passed in House. No consideration in Senate.

S. 1379 procedural history

The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (S. 1379) was introduced in the Senate by Richard Burr on May 8, 2019. On May 15, the Senate Committee on Health, Education, Labor, and Pensions passed the bill by unanimous consent. That same day, the full Senate passed the bill by voice vote. [22]

On June 4, the House passed the bill by voice vote. The legislation was sent to President Trump on June 13, [22] who signed it into law on June 24, 2019 as Public Law 116-22. [23]

See also

2013 National Response Framework National Response Framework 2013-05-01.pdf
2013 National Response Framework

Related Research Articles

<span class="mw-page-title-main">Bioterrorism</span> Terrorism involving biological agents

Bioterrorism is terrorism involving the intentional release or dissemination of biological agents. These agents are bacteria, viruses, insects, fungi, and/or toxins, and may be in a naturally occurring or a human-modified form, in much the same way as in biological warfare. Further, modern agribusiness is vulnerable to anti-agricultural attacks by terrorists, and such attacks can seriously damage economy as well as consumer confidence. The latter destructive activity is called agrobioterrorism and is a subtype of agro-terrorism.

Biodefense refers to measures to restore biosecurity to a group of organisms who are, or may be, subject to biological threats or infectious diseases. Biodefense is frequently discussed in the context of biowar or bioterrorism, and is generally considered a military or emergency response term.

The Strategic National Stockpile (SNS), originally called the National Pharmaceutical Stockpile (NPS), is the United States' national repository of antibiotics, vaccines, chemical antidotes, antitoxins, and other critical medical supplies. Its website states:

"The Strategic National Stockpile's role is to supplement state and local supplies during public health emergencies. Many states have products stockpiled, as well. The supplies, medicines, and devices for life-saving care contained in the stockpile can be used as a short-term stopgap buffer when the immediate supply of adequate amounts of these materials may not be immediately available."

The Biodefense and Pandemic Vaccine and Drug Development Act of 2005, nicknamed "Bioshield Two" and sponsored by Senator Richard Burr, aims to shorten the pharmaceutical development process for new vaccines and drugs in case of a pandemic, and to protect vaccine makers and the pharmaceutical industry from legal liability for vaccine injuries. The proposed bill would create a new federal agency, the Biomedical Advanced Research and Development Agency (BARDA), that would act "as the single point of authority" to promote advanced research and development of drugs and vaccines in response to bioterrorism and natural disease outbreaks, while shielding the agency from public Freedom of Information Act (FOIA) requests. BARDA would be exempt from long-standing open records and meetings laws that apply to most government departments.

<span class="mw-page-title-main">Public Health Service Act</span> US federal law

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<span class="mw-page-title-main">Public Readiness and Emergency Preparedness Act</span> US law

The Public Readiness and Emergency Preparedness Act (PREPA), passed by the United States Congress and signed into law by President of the United States George W. Bush in December 2005, is a controversial tort liability shield intended to protect vaccine manufacturers from financial risk in the event of a declared public health emergency. The part of PREPA that actually affords such protection is now codified at 42 U.S.C. § 247d-6d. The act specifically affords to drug makers immunity from actions related to the manufacture, testing, development, distribution, administration and use of medical countermeasures against chemical, biological, radiological and nuclear agents of terrorism, epidemics, and pandemics. PREPA strengthens and consolidates the oversight of litigation against pharmaceutical companies under the purview of the secretary of Health and Human Services (HHS). PREPA provides $3.8 billion for pandemic influenza preparedness to protect public health in the case of a pandemic disease outbreak.

<span class="mw-page-title-main">Public Health Security and Bioterrorism Preparedness and Response Act of 2002</span>

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The Global Health Security Initiative (GHSI) is an informal international partnership among countries in order to exchange information and coordinate practices for confronting new threats and risks to global health. It was formed to respond to threats of biological, chemical, or radio-nuclear terrorism (CBRN), with pandemic influenza added to the scope a year later.

<span class="mw-page-title-main">Project Bioshield Act</span> US law

The Project Bioshield Act was an act passed by the United States Congress in 2004 calling for $5 billion for purchasing vaccines that would be used in the event of a bioterrorist attack. This was a ten-year program to acquire medical countermeasures to biological, chemical, radiological, and nuclear agents for civilian use. A key element of the Act was to allow stockpiling and distribution of vaccines which had not been tested for safety or efficacy in humans, due to ethical concerns. Efficacy of such agents cannot be directly tested in humans without also exposing humans to the chemical, biological, or radioactive threat being treated, so testing follows the FDA Animal Rule for pivotal animal efficacy.

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<span class="mw-page-title-main">Biomedical Advanced Research and Development Authority</span> Government organization in Washington D.C., United States

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<span class="mw-page-title-main">Pandemic and All-Hazards Preparedness Act</span> U.S. Federal law

On December 19, 2006, the Pandemic and All-Hazards Preparedness Act (PAHPA), Public Law No. 109-417, was signed into law by President George W. Bush. First introduced in the House by Rep. Mike Rogers (R-MI) and Rep. Anna Eshoo (D-CA), PAHPA had broad implications for the United States Department of Health and Human Services's (HHS) preparedness and response activities. Among other things, the act amended the Public Health Service Act to establish within the department a new Assistant Secretary for Preparedness and Response (ASPR); provided new authorities for a number of programs, including the advanced development and acquisitions of medical countermeasures; and called for the establishment of a quadrennial National Health Security Strategy.

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<span class="mw-page-title-main">Pandemic and All-Hazards Preparedness Reauthorization Act of 2013</span>

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The Bipartisan Commission on Biodefense, formerly known as the Blue Ribbon Study Panel on Biodefense, is an organization of former high-ranking government officials that analyzes US capabilities and capacity to defend against biological threats. According to the Commission's mission statement, the organization was formed to "provide for a comprehensive assessment of the state of U.S. biodefense efforts, and to issue recommendations that will foster change."

<span class="mw-page-title-main">Strengthening Public Health Emergency Response Act of 2015</span>

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